中华医学美学美容杂志
中華醫學美學美容雜誌
중화의학미학미용잡지
CHINESE JOURNAL OF MEDICAL AESTHETICS AND COSMETOLOGY
2011年
4期
260-262
,共3页
乳房假体%乳房再造术%乳腺切除术%肌瓣
乳房假體%乳房再造術%乳腺切除術%肌瓣
유방가체%유방재조술%유선절제술%기판
Breast prothesis%Breast reconstruction%Subcutaneous mastectomy%Combined muscle flap
目的 探讨经乳房外侧弧形切口皮下乳腺切除术后,带蒂转移背阔肌肌瓣,与胸大肌肌瓣形成联合肌瓣覆盖乳房假体,进行即刻乳房再造术的治疗效果.方法 选择临床分期为Ⅰ期或Ⅱ期,肿瘤未侵及皮肤和胸肌的乳腺癌患者共30例,经乳房外侧弧形切口皮下切除乳腺腺体并清扫腋窝淋巴结,利用同一切口,切取背阔肌肌瓣带蒂转移,分离胸大肌下间隙,切断胸大肌下缘与胸壁附着处直至胸骨边缘,将转移的背阔肌肌瓣与胸大肌断缘缝合,组成联合肌瓣,形成宽大的包裹假体的腔隙,置入假体.结果 30例再造乳房外形及手感良好,其中优22例(73.3%),良8例(26.7%).术后所有患者均随访半年以上,均无瘤生存.结论 再造乳房形态美观,能够置入较大的假体,不增加背部的切口,适合于无淋巴结转移、对侧乳房无明显下垂的早期青年乳腺癌患者的即刻乳房再造.
目的 探討經乳房外側弧形切口皮下乳腺切除術後,帶蒂轉移揹闊肌肌瓣,與胸大肌肌瓣形成聯閤肌瓣覆蓋乳房假體,進行即刻乳房再造術的治療效果.方法 選擇臨床分期為Ⅰ期或Ⅱ期,腫瘤未侵及皮膚和胸肌的乳腺癌患者共30例,經乳房外側弧形切口皮下切除乳腺腺體併清掃腋窩淋巴結,利用同一切口,切取揹闊肌肌瓣帶蒂轉移,分離胸大肌下間隙,切斷胸大肌下緣與胸壁附著處直至胸骨邊緣,將轉移的揹闊肌肌瓣與胸大肌斷緣縫閤,組成聯閤肌瓣,形成寬大的包裹假體的腔隙,置入假體.結果 30例再造乳房外形及手感良好,其中優22例(73.3%),良8例(26.7%).術後所有患者均隨訪半年以上,均無瘤生存.結論 再造乳房形態美觀,能夠置入較大的假體,不增加揹部的切口,適閤于無淋巴結轉移、對側乳房無明顯下垂的早期青年乳腺癌患者的即刻乳房再造.
목적 탐토경유방외측호형절구피하유선절제술후,대체전이배활기기판,여흉대기기판형성연합기판복개유방가체,진행즉각유방재조술적치료효과.방법 선택림상분기위Ⅰ기혹Ⅱ기,종류미침급피부화흉기적유선암환자공30례,경유방외측호형절구피하절제유선선체병청소액와림파결,이용동일절구,절취배활기기판대체전이,분리흉대기하간극,절단흉대기하연여흉벽부착처직지흉골변연,장전이적배활기기판여흉대기단연봉합,조성연합기판,형성관대적포과가체적강극,치입가체.결과 30례재조유방외형급수감량호,기중우22례(73.3%),량8례(26.7%).술후소유환자균수방반년이상,균무류생존.결론 재조유방형태미관,능구치입교대적가체,불증가배부적절구,괄합우무림파결전이、대측유방무명현하수적조기청년유선암환자적즉각유방재조.
Objective To explore immediate implanting breast reconstruction after subcutaneous mastectomy by through breast lateral curved incision with combined muscle flap of pedicled latissimus dorsi and pectoralis major muscle covering the breast prosthesis. Methods 30 patients were selected in clinical stage Ⅰ or Ⅱ , and without involvement of skin and pectoral muscle. After subcutaneous mastectomy through breast lateral curved incision, by the same incision the latissimus dorsi muscle flap was removed and transferred, and the submuscular interspace was dissected, and the inferior border of the pectoralis major muscle was cut off. The pedicled latissimus dorsi and pectoralis major muscle flap were sutured and the combined muscle flap was formed to cover the breast prothesis.Results The shape and feeling were satisfactory in 30 reconstructive breasts, and 22 cases were excellent (73.3 %), and 8 cases were good (26.7 %). All the patients survived without tumor recurrence after following-up more than half a year. Conclusions The method has advantages of good cosmetic breast shape, without appendant incision, and larger breast prosthesis could be insertted. It is a good method of immediate breast reconstruction for the young women with early stage breast cancer without axillary lymph node metastasis.
